A Community-BasedPositive Deviance/HearthInfant and Young Child Nutrition Intervention in Ecuador Improved Diet and Reduced Underweight

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Abstract

Objective:

Underweight and stunting are serious problems in Ecuador that require interventions in the first 2 years of life. The researchers assessed the effectiveness of a Positive Deviance (PD)/Hearth community-based intervention using local foods to improve infant and young children's nutrition.

Design:

A quasi-experimental nonrandomized study was conducted between March and October, 2009.

Setting:

The intervention and study were implemented in the Ecuadorian highlands provinces of Chimborazo and Tungurahua.

Participants:

Eighty mother–child pairs in 6 intervention communities and 184 mother–child pairs in 9 comparison communities.

Intervention:

Mothers met in participatory peer-led PD/Hearth cooking and nutrition education sessions for 12 days.

Main Outcome Measures:

Dietary intake and nutritional status were collected at baseline and 6-month follow-up.

Analysis:

Multiple linear and logistic regression were used for growth outcomes, and ANCOVA for mean dietary intakes.

Results:

Mothers in the intervention were 1.3–5.7 times more likely to feed their children the promoted foods (P < .05). Children in the intervention consumed a higher percentage of recommended intakes for iron, zinc, vitamin A, protein, and energy (P < .05) at follow-up and had improvements in weight-for-age z-score (β = .17; 95% confidence interval, 0.01–0.31). Likelihood of underweight was reduced for children in the intervention (odds ratio = 0.36; 95% confidence interval, 0.13–0.96)

Conclusions and Implications:

The PD/Hearth interventions support mothers to improve infant and young children's nutrition practices and reduce underweight.

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